Betamethasone / Clotrimazole

Betamethasone / Clotrimazole pairs a corticosteroid with an imidazole antifungal in a single cream. Clotrimazole works against the organisms behind the infection, while betamethasone dipropionate calms the inflammation and itch that come with it. According to the UK SmPC for the licensed equivalent, the cream is meant for short-term treatment of tinea infections (athlete's foot, ringworm of the body and groin infections caused by Trichophyton, Epidermophyton and Microsporum species) and of skin candidiasis caused by Candida albicans. It is not a general-purpose rash cream: a steroid applied to an unidentified rash can mask or worsen some conditions.

On this page the cream is supplied in 10 g tubes, and you can choose a pack of 2, 4, 6 or 12 tubes. Check the strength of each ingredient printed on the tube, as imported products are not always identical in composition to the UK brand.

The product listed here is an imported generic and does not carry a UK marketing authorisation of its own. In the UK this combination is licensed as Lotriderm cream, held by Organon Pharma (UK) Limited. Lotriderm contains betamethasone dipropionate 0.064% w/w (equivalent to 0.05% betamethasone) with clotrimazole 1% w/w and is classed as a prescription-only medicine (POM).

The UK SmPC covers adults and children over 12. The cream goes on twice a day: for two weeks in groin infections, body ringworm and candidiasis, and for four weeks in athlete's foot. It is for the skin only, must not be covered with an occlusive (airtight) dressing and should be kept out of the eyes. On the face, a course is limited to five days. Long, continuous use on large areas of broken skin or in skin folds raises the chance of both local and whole-body steroid effects, which is why these courses are deliberately short. If the skin has not improved by the end of the recommended period, the diagnosis needs another look.

The SmPC rules out use in anyone sensitive to its ingredients, to other corticosteroids or to imidazole antifungals. It is also contraindicated in facial rosacea, acne vulgaris, perioral dermatitis, nappy rash and in bacterial or viral skin infections. Use in psoriasis carries particular risks, including rebound flares. It is not recommended for children under 12, and long continuous treatment should be avoided in children of any age. In pregnancy it is used only if the benefit justifies the risk, and never in large amounts or for long periods; caution also applies while breastfeeding. Lotriderm contains cetostearyl alcohol, propylene glycol and benzyl alcohol, which can irritate the skin or cause allergic reactions in some people; check the ingredient list on your own tube.

Reported effects include burning and stinging, itching, redness, peeling, dryness and general skin irritation. Repeated or prolonged steroid use may lead to thinning of the skin, stretch marks, changes in pigmentation, folliculitis and acne-like spots, as well as secondary infection. Blurred vision or other changes in sight should be reported, because topical corticosteroids have been linked to cataract, glaucoma and central serous chorioretinopathy. If marked irritation develops, the cream should be stopped and advice sought.

Whether Betamethasone / Clotrimazole is right for a particular rash, and for how long, is a decision for the doctor or prescriber who examines the skin.